Medical Treatment of Perianal Crohn Disease Fistulae
Author, Year N Drug, Dose Rx Time Response Drug Response Placebo P-value Willoughby et al., 1971 [75] 3 AZA, 2 mg/kg/day 24 week 0/2 (0%) 0/1 (0%) NR Rhodes et…
Infliximab Therapy for Pediatric Crohn Disease and Ulcerative Colitis
Fig. 33.1 Design of the REACH study in pediatric Crohn disease Post hoc analyses of the REACH study evaluated the effect of infliximab in children with perianal CD. Seventy percent…
Methotrexate
Increased interleukin (IL)-10 Increased IL-2 Inhibition of neutrophil chemotaxis Decreased leukotriene B4 (LTB4) Decreased tumor necrosis factor alpha Decreased IL-6 Decreased IL-8 Decreased selective adhesion molecules (SAM) Improved understanding of…
6-Mercaptopurine Therapy
Fig. 31.1 Azathioprine (AZA) metabolism (XO xanthine oxidase; 6-TU 6-thiouric acid; 6-TIMP 6-thioinosine monophosphate) An apparent genetic polymorphism has been observed in TPMT activity in both the Caucasian and African-American…
Corticosteroids
Budesonide n = 22 Prednisolone n = 26a p-value Moon face 5 15 0.01 Buffalo hump 0 1 NS Acne 1 7 0.033 Hirsutism 2 3 NS Skin striae…
Nutritional Management of Inflammatory Bowel Disease
3. Kanof ME, Lake AM, Bayless TM. Decreased height velocity in children and adolescents before the diagnosis of Crohn’s disease. Gastroenterology. 1988;95(6):1523–7.PubMed 4. Levine A, et al. Consensus and controversy…
Antibiotic Therapy
2. Rutgeerts P, Goboes K, Peeters M, et al. Effect of faecal stream diversion on recurrence of Crohn disease in the neoterminal ileum. Lancet. 1991;338:771–4.PubMedCrossRef 3. Perencevich M, Burakoff R….
Inflammatory Bowel Diseases and Skeletal Health
Fig. 13.1 Bone modeling and remodeling. Bone modeling occurs uniquely in children and results from the combined activities of osteoblasts, osteoclasts and the growth plate cells. Its result is bone…
Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease
Extraintestinal manifestation Prevalence Growth failure ++++ Sacroiliitis ++++ Osteoporosis/osteopenia +++ Peripheral joint inflammation +++ Aphtous lesions +++ Primary sclerosing cholangitis ++ Granulomatous skin lesion ++ Erythema nodosum ++ Pyoderma gangrenosum…
Laboratory Evaluation of Inflammatory Bowel Disease
Test Findings Significance Complete blood count and differential Anemia (microcytic, macrocytic, normocytic), thrombocytosis, leukocytosis Anemia: Assess severity of blood loss, evaluate for iron and other macronutrient deficiencies. Reported prevalence 16–77%…
